Provider Demographics
NPI:1609009141
Name:SPIELES, LINDSEY M (PA-C)
Entity Type:Individual
Prefix:
First Name:LINDSEY
Middle Name:M
Last Name:SPIELES
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 JOHN ST
Mailing Address - Street 2:SUITE M-424
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49007-5341
Mailing Address - Country:US
Mailing Address - Phone:269-349-3350
Mailing Address - Fax:269-349-2403
Practice Address - Street 1:601 JOHN ST
Practice Address - Street 2:SUITE M-424
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49007-5341
Practice Address - Country:US
Practice Address - Phone:269-349-3350
Practice Address - Fax:269-349-2403
Is Sole Proprietor?:No
Enumeration Date:2009-09-01
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5601005594363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0203907382OtherBCBS
MI700C976180OtherBCBS
MI0203907382OtherBCBS